Researchers have identified that eye scans may offer a way to detect atrial fibrillation (AF), a common heart condition associated with an increased risk of stroke, several years before traditional diagnosis methods. The study, conducted by teams at Moorfields Eye Hospital NHS Foundation Trust and University College London’s Institute of Ophthalmology, analysed eye scan data from over 90,000 individuals to investigate links between retinal biomarkers and AF.
Atrial fibrillation affects an estimated 1.5 million people in the United Kingdom, with many cases remaining undiagnosed due to the condition’s sometimes asymptomatic and intermittent nature, which can cause it to be missed by standard electrocardiogram (ECG) tests. AF is characterised by an irregular heartbeat and can lead to the formation of blood clots that increase the risk of stroke and other cardiovascular complications.
The study involved data from two major sources: the AlzEye study, which included 50,651 people, and the UK Biobank, involving 39,013 participants. Among the collective group, 6,261 patients had a confirmed diagnosis of AF. Researchers found that those with AF exhibited distinctive features in their retinas, specifically thinner retinal layers, believed to result from reduced blood flow to retinal nerve cells caused by the impact of AF-related mini-strokes in the brain.
Additionally, individuals who did not have AF at the time of their eye scans, but later developed the condition, also showed thinner retinal layers on average four years before being diagnosed. This suggests that retinal imaging may detect early signs of AF before symptoms emerge or before the condition is clinically confirmed.
Josef Huemer, the lead author and consultant ophthalmologist at Moorfields Eye Hospital, stated that while these findings require further research for confirmation, routine eye examinations could potentially serve as a tool to identify individuals who might benefit from more detailed cardiac assessments. Early detection could allow for timely treatment with therapies aimed at reducing the long-term risk of stroke and other complications linked to AF.
Experts emphasised that retinal imaging is not intended to replace ECG-based diagnosis, but could act as a complementary, non-invasive, and accessible screening method. Siegfried Wagner, a research fellow at UCL, noted the advantages of this approach, highlighting that eye scans are quick, widely available, and do not involve invasive procedures.
The research builds on growing evidence supporting the use of ocular imaging to detect systemic diseases—a field known as oculomics. Prior work by the Moorfields team has demonstrated that eye scans can help identify early signs and assess the progression risk of various eye conditions such as age-related macular degeneration, glaucoma, and diabetic retinopathy, as well as neurological disorders and cardiovascular disease.
A Moorfields patient, John Brewer, recounted his AF diagnosis only emerging during cataract surgery when an irregular heartbeat was detected. He reflected that earlier detection through routine retinal scans in his regular eye appointments might have prevented the distressing experience, underscoring the potential benefits of this emerging diagnostic approach.